Despite advances in blood culture practices and technology, false-positive blood culture results due to contaminants continue to be a critical problem. Blood culture contamination rate, the primary indicator of preanalytic performance in microbiology, is associated with increased length of hospital stay, additional expense, and the administration of unnecessary antibiotics.
The CAP and other accrediting organizations require you to monitor and evaluate key indicators of quality for improvement opportunities. Use this monitor to help meet CAP Laboratory Accreditation Checklist statement note MIC.22630: "It is recommended that blood culture statistics, including number of contaminated cultures, be maintained and reviewed regularly by the laboratory director. The laboratory should establish a threshold for an acceptable rate of contamination. Tracking the contamination rate and providing feedback to phlebotomists or other persons drawing cultures has been shown to reduce contamination rates." This will also help laboratories meet The Joint Commission Standard QSA 04.07.01 EP3.
Objective
Determine the rate of blood culture contamination using standardized criteria for classifying contaminants.
Data Collection
On a monthly basis, participants will tabulate the total number of blood cultures processed and the total number of contaminated blood cultures. Blood cultures from neonatal patients are tabulated separately. For the purposes of this study, participants will consider a blood culture to be contaminated if they find one or more of the following organisms in only one of a series of blood culture specimens: Coagulase-negative Staphylococcus; Micrococcus; Alpha-hemolytic viridans group streptococci; Propionibacterium acnes; Corynebacterium sp. (diptheroids); or Bacillus sp. Participants have the option to monitor institution-specific subgroups, for example, a specific department or patient population.
Performance Indicators
- Neonatal contamination rate (%)
- Other contamination rate (%)
- Overall contamination rate (%)
Shipping Schedule
- Shipment A: December 9, 2019
- Shipment B: March 2, 2020
- Shipment C: June 1, 2020
- Shipment D: August 31, 2020
Additional Information
Participants in the Q-TRACKS program receive:
- Users Guide
- Templates and instructions for data collection
- Quarterly reports that include fingerprint clusters, customer-defined groups, and all institution comparisons
- Peer directory
Q-TRACKS activities meet the American Board of Pathology MOC Part IV Practice Performance Assessment requirements.
For Comprehensive Collection of Tools, see Quality Management Tools.
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Clinical Pathology |
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Patient Safety |
Microbiology |
Transfusion Medicine |
Chemistry/ Hematology |
Customer Satisfaction |
Q-PROBES |
Technical Competency Assessment of Peripheral Blood Smears (QP201)![](images/iStore_NEWicon.png) |
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Red Blood Cell Utilization: Single and Double Unit Transfusions (QP202)![](images/iStore_NEWicon.png) |
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Inpatient Test Utilization and Volume Benchmarking (QP203)![](images/iStore_NEWicon.png) |
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Turnaround Time for Image with Guided Breast Needle Biopsy Specimens (QP204)![](images/iStore_NEWicon.png) |
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Q-TRACKS |
Patient Identification Accuracy (QT1) |
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Blood Culture Contamination (QT2) |
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Laboratory Specimen Acceptability (QT3) |
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In-Date Blood Product Wastage (QT4) |
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Gynecologic Cytology Outcomes:
Biopsy Correlation Performance (QT5) |
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Satisfaction with Outpatient Specimen Collection (QT7) |
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Stat Test Turnaround Time Outliers (QT8) |
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Critical Values Reporting (QT10) |
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Troponin Turnaround Times (QT15) |
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Corrected Results (QT16) |
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Outpatient Order Entry Errors (QT17) |
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*The CAP requires accredited laboratories to have a quality management plan that covers all areas of the laboratory and includes benchmarking key measures of laboratory performance (GEN.13806, GEN.20316, COM.04000). The Joint Commission requires accredited hospitals to regularly collect and analyze performance data (PI.01.01.01, PI.02.01.01). CLIA requires laboratories to monitor, assess, and correct problems identified in preanalytic, analytic, and postanalytic systems (§493.1249, §493.1289, §493.1299).